Gastric histopathology in laparoscopic sleeve gastrectomy: pre- and post-operative comparison

Abstract

Background: Sleeve gastrectomy (SG) produces excellent results in weight reduction and resolution of comorbidities. The histology of the gastric mucosa can be affected by the surgical procedure, with alterations of inflammatory patterns. The objective of this study is to evaluate alterations of the inflammatory patterns of the gastric mucosa in SG and the results in weight loss and resolution of comorbidities.

Methods: Morbidly obese patients were selected to undergo SG. Endoscopies were performed pre-operatively and post-operatively after 6 months, with an incisura and 3 cm before the pylorus biopsies. Data on weight, height, and associated diseases were collected. The data were compared, and the biopsies evaluate the inflammatory patterns.

Results: There was a reduction of body weight with a pre-operative weight of 132.5 ± 15.7 kg and a post-operative weight of 95.8 ±10.6 kg with a p < 0.001. Also, the body mass index (BMI) was reduced significantly with a mean pre-operative of 42.6 ± 10.6 kg/m(2) and a post-operative of 30.9 ± 3.2 kg/m(2) with a p < 0.001. The comorbidities were all resolved or improved. The pattern of gastric histology showed chronic gastritis with inflammatory activity associated with Helicobacter pylori in 33.3 % of the patients, along with foveolar hyperplasia at 58.3 %. The chronic gastritis with discrete inflammatory activity was reduced by 16.7 %, and the foveolar hyperplasia was reduced by 33.3 %.

Conclusion: The inflammatory alterations in the pre-operative period were mainly foveolar hyperplasia and chronic gastritis associated with H. pylori, and they were reduced in the post-operative period. A significant reduction of weight and BMI occurred, and a resolution of comorbidities was observed.